Provider Demographics
NPI:1194797381
Name:RAGAA Z ISKAROUS MD INC
Entity type:Organization
Organization Name:RAGAA Z ISKAROUS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THE DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAGAA
Authorized Official - Middle Name:ZAKHER
Authorized Official - Last Name:ISKAROUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-869-1038
Mailing Address - Street 1:11411 BROOKSHIRE AVE
Mailing Address - Street 2:#201
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241
Mailing Address - Country:US
Mailing Address - Phone:562-869-1038
Mailing Address - Fax:562-862-9913
Practice Address - Street 1:11411 BROOKSHIRE AVE
Practice Address - Street 2:#201
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241
Practice Address - Country:US
Practice Address - Phone:562-869-1038
Practice Address - Fax:562-862-9913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA045155208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A451550Medicaid
E59429Medicare UPIN
CAA45155Medicare ID - Type Unspecified